A new monospecific ovine Fab fragment antivenom for treatment of envenoming by the Sri Lankan Russell's viper (Daboia russelii russelii):: a preliminary dose-finding and pharmacokinetic study
A new monospecific ovine Fab fragment antivenom for treatment of envenoming by the Sri Lankan Russell's viper (Daboia russelii russelii):: a preliminary dose-finding and pharmacokinetic study
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DOI：
10.4269/ajtmh.1999.61.259
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发表时间：
1999-08-01
影响因子：
3.3
通讯作者：
Warrell, DA
中科院分区：
文献类型：
--
作者：
Ariaratnam, CA;Meyer, WP;Warrell, DA
拉塞尔的毒蛇是斯里兰卡危及生命的蛇咬伤和急性肾功能衰竭的最重要原因，只有从印度进口的马多特异性抗蛇毒血清可用。它们在临床上或清除毒液抗原血症方面都没有被证明是有效的，而且它们经常引起反应。为了减少死亡率和发病率，一种新的单特异性绵羊Fab片段抗蛇毒血清(PolongaTab(TM)；治疗抗体，Inc.，伦敦，英国)被用于对抗斯里兰卡拉塞尔的毒蛇毒素。在对35名患者进行的初步剂量发现研究中，即使在严重中毒的患者中，初始剂量3-4g也永久恢复了血液的凝固性，并停止了全身出血。蛇毒抗原血症在抗蛇毒血清治疗后1小时内消失，但在治疗性抗体迅速清除后，可能是由于被咬伤部位的毒液持续吸收而复发。12名患者(34%)经历了通常轻微的早期反应，并且总是对肾上腺素有反应。
Russell's viper is the most important cause of life-threatening snake bite and acute renal failure in Sri Lanka, Only equine polyspecific antivenoms imported from India are available. They have not proved effective clinically or in clearing venom antigenemia and they frequently cause reactions. In an attempt to reduce mortality and morbidity, a new monospecific ovine Fab fragment antivenom (PolongaTab(TM); Therapeutic Antibodies, Inc., London, United Kingdom) was raised against Sri Lankan Russell's viper venom. In a preliminary dose-finding study in 35 patients, an initial dose of 3-4 g restored blood coagulability permanently and stopped systemic bleeding, even in severely envenomed patients. Venom antigenemia disappeared within 1 hr of antivenom treatment but recurred, probably as a result of continued absorption of venom from the site of the bite, after the rapid clearance of therapeutic antibody. Twelve patients (34%) experienced early reactions that were usually mild and always responded to epinephrine.